BPD-DS done in 2007 15 years post op. I have severe Osteoporosis due to malabsorption, mostly self inflicted by not being diligent with my vitamins and supplements. Stopped losing weight, eating a good healthy diet, assumed I was getting what I needed did not take supplements on a regular basis. Fast forward to today, I've been faithfully taking vitamins, calcium, iron for about 2 years now but I can't seem to slow the cycle of osteoporosis. I'm taking tymlos injections nightly, but my bone scans steadily decline. Any suggestions for Oral or patch Calcium that is extremely quickly absorbable please share info.

What has your doctor recommended? If your bone loss & calcium absorption level is poor they should have you on appropriate meds, etc. to help you better manage it. A friend was put a high calcium diet (including more dairy, oily fish, tinned fish with soft bones -salmon, mackerel, beans, etc.) to support hers. She walks a fine line though as she also has a heart condition & too much calcium cause heart issues.

How are your vitamin D levels? Your body needs D to help absorb calcium. Not sure if you drink alcohol but it impedes the body’s ability to absorb calcium & vitamin D.

I was prescribed Creons (pancreatic enzymes) to help with my protein malabsorption issues. I believe they can help many malabsorption issues. Worth asking your doctor.

Are you still in touch with your DS surgeon (are they still in practice?) They would be your first source of help as they know all of the odd quirks of the DS (my wife is a DS, class of 2005.) Standard calcium citrate is the most absorbable that I know of; the patches seem to work for some but not for others, mostly not from what I have seen from other DSers. Also to look into is the entire calcium/absorption complex - vit D3, of course, but also K (usually K2) and also magnesium. I would expect with your problems that the thyroid numbers have been checked and things are going the right way, but that is something to be up on as well. Is there an RD (dietician) associated with your surgeon's practice, or elsewhere who is knowledgeable about the DS (not just bariatrics, but the DS specifically.) An endocrinologist can also be very helpful with these problems, again particularly if they are familiar with the DS. I don't think that there are any injectable/infusable forms like there is for iron, but I don't think that getting it into the bloodstream is the hard part, (just the first step,) but rather getting it from the blood into the bones (and not the other way) and that is the tricky part where there can be lots of subtleties.

if you're already on tymlos, I'm not sure if calcium supplements are going to help much. Are you working with a specialist? I have osteoporosis, and my PCP referred me to an endocrinologist who specializes in it. If you're not already working with a specialist, I'd see if my PCP could refer me to one. Sounds like you have a complicated case. Maybe they could just try a different drug (??)